Podcast: Turning Stress into Strength: Bipolar Management Strategies
Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.
Announcer: You’re listening to Inside Bipolar, a Healthline Media Podcast, where we tackle bipolar disorder using real-world examples and the latest research.
Gabe: Welcome, everybody. You’re listening to the Inside Bipolar podcast. My name is Gabe Howard and I live with bipolar disorder.
Dr. Nicole: And I’m Dr. Nicole Washington, a board-certified psychiatrist.
Gabe: And today we’re going to talk about stress proofing our routine to better manage bipolar disorder. And this is another one of those emails that we received from alert listeners, like all of you, asking us to cover some just basic ideas and some takeaways that people can do to better manage their lives when the symptoms of bipolar disorder come a calling. So keep those coming in. Just hit us up at [email protected], or leave us comments or reviews or share the show. I think I’ve plugged enough. Dr. Nicole, this whole idea of a stress free life? It handcuffs me a little bit because I think it might be one of those unrealistic goals that people believe that they need to meet, but is actually impossible.
Dr. Nicole: I agree with you 100%. I don’t know what a stress free life looks like, because so many of the things that bring stress to us are things that are not under our control. We don’t have much control over a lot of things that happen around us. So I agree with you. I don’t know how I feel about this stress free life. I don’t think I don’t think it’s possible I don’t.
Gabe: I think what you actually need is I’m going to take an engineering principle. Right.
Gabe: Foundations of buildings are designed to take on vast amounts of stress, and the stress
Gabe: Holds the building up. And if you’ve got a solid foundation, then the stress is still there. It’s just irrelevant. The house stays up, people utilize the buildings, the house, etc. but the stress is not removed. And
Gabe: In fact, again, not an engineer. I am not an engineer. I want to be very clear. Not a doctor, not an engineer. But I’m told that if you don’t balance that stress correctly, the building will topple.
Dr. Nicole: Okay. So you have given a million analogies in our time together. This might be my favorite one. This might be the one I love that I do think that having a foundation that can withstand the stress and that can allow you to make the necessary movements you need to make to handle it without toppling is fantastic.
Gabe: Of the things that I think about in managing stress and managing bipolar disorder is I call it picking your battles. For example, when you’re in the middle of a manic episode, a depressive episode, when you’re struggling in any way, now is not the time to have deep conversations with your loved ones about all the things that they’re doing to tick you off.
Dr. Nicole: Yes. Do not decide to air all of your grievances with folks when you’re in one of those episodes. I do think that’s a good one, but how do you see that as like helping the stress free like does. I mean, I guess, yes, it adds to the stress. I’m literally walking through this in my brain as you’re saying it. Yes. If you decide to air out all of the grievances you have with folks when you’re either manic or depressed, that is going to add some stress and it may not add it in that moment. So I think that’s the important thing. It may not add it in that moment for you, but once you’re out of that episode and all is said and done and you have to deal with the consequences of that episode, there is going to be some stress there for sure.
Gabe: I think it adds stress both in the moment and later, because sometimes the best course of action is to wait, is to wait and see what happens. Maybe the thing that your loved one is doing that is annoying the hell out of you is actually just a reaction to the symptom of bipolar disorder. I know that my wife is much more annoying when I’m depressed. You know her happy go lucky attitude. Her Pollyanna. Her oh, I love you so much, I don’t want to hear it. So my knee jerk reaction is to lash out and say, look, things aren’t great. Things suck.
Gabe: And that would make me feel better in the moment. Until of course, I saw her reaction. Now I’ve got two problems. Now I’ve got the stress of the depression of bipolar disorder and the stress of I hurt my wife, or at the very least, even if I can’t see it as she’s hurt, I have the stress of dealing with the fallout of that.
Dr. Nicole: Yeah. Or the guilt
Gabe: Or the guilt. Right?
Dr. Nicole: Or whatever. Yeah. All of that.
Gabe: Whatever it looks like. I think one of the hallmarks of bipolar disorder, at least it very much is for me, and for a lot of people that I’ve talked to, is this desire that whatever we’re feeling right now must be dealt with right now. We have this this urge to do it now. And I want the people listening to know that waiting is actually a choice. It is a
Gabe: Course of action. Some people believe that if they do nothing, then they’ve done nothing and they’re not trying to get better. And they don’t really see that by waiting to talk to their loved one about the thing that’s annoying them, or waiting to make that big decision until they’re in a better emotional state is actually a choice. And it’s actually self-care and self-advocacy. Most people are reframing that. As I froze, I did nothing. I’m
Gabe: Ignoring the elephant in the room. I don’t think any of that is true. I think when we are not at our best mentally because of bipolar disorder, we should, to the extent possible, try to mitigate our interactions with other people and maybe ask for some space and ask to table bigger conversations for later.
Dr. Nicole: I think that happens outside of bipolar disorder as well though. I
Gabe: [Laughter] I agree, I do too.
Dr. Nicole: Think, I think I think when tensions are high people are like oh no we’re going to deal with this right now. We’re going to, we’re going to, we’re going to deal with this right now. That’s not the time when you’re upset and angry and emotions are high. So I guess really, when you’re in any extreme emotional state, whether that’s depression, whether that’s mania. Although I will say if you’re in the middle of a of a manic episode, and especially if it’s a more severe episode, your ability to recognize that now is not the time just may not be there. There’s all the impulsivity that comes with that, and just the lack of awareness of how you’re presenting in that moment. It just may not be there.
Gabe: So I’m really glad that you brought that up, because that does raise the question. Okay, Gabe is saying not to do something. Dr. Nicole agrees with him. All right. How do I do that? Right. And you
Gabe: Went. You went straight for the jugular, Dr. Nicole. When you are manic and the whole world revolves around you, and you are the most important thing ever, how can you convince yourself to let it go or to wait or to give it a beat? I don’t
Gabe: Know the answer to that question.
Dr. Nicole: I don’t know that you can like, I think it’s okay to say that when you have bipolar disorder, you are going to experience certain mood states, especially if you are known to have more severe mania. You are absolutely going to experience mood states that you’re going to have very little control. But I think that’s also kind of what you mean by let’s have these conversations outside of let’s let’s come back after let’s we always talk about plans and we talk about preparing for future episodes when you’re stable, like we always talk about these things. And really those plans are to help minimize some of the stress that is going on during these episodes. I don’t know that in the middle of a mania, you can expect a person, especially if it’s a more severe manic episode. I just don’t know that you can expect someone to be able to have a reasonable conversation, or to have enough control over themselves to not impulsively blurt out what they’re thinking, or things like that.
Gabe: This is always the very hard conversation to have, because I want the show to just be all of these things that you can do to make your life better, right? If you’re feeling X, do Y and Z will be the outcome, and hopefully the Z outcome is the desired outcome. If not, we’ll give you another tip later in the show and use that one. The reality is, is bipolar disorder is an illness and sometimes it’s not so simple. If you are so far gone that you don’t have control. Then we started talking about an ounce of prevention is worth a pound of cure. Obviously, one of the things that you can do to try to lead a stress free life is to manage those symptoms really, really well. And that’s where things
Gabe: Like therapy, coping skills, mindfulness, medication, resiliency, all of these factors come in because you don’t want to get so far gone that you’re just out of control. But one of the things I want to touch on for this particular episode, managing stress, is setting expectations with those you love. I think people with bipolar disorder are generally very poor at this. We don’t necessarily do a really good job of telling our support system, look, there may be. In fact, there’s likely to be a time in the future where I’m going to say or do something that’s out of character for me and that you’re not going to like, and I need you in the moment to be aware of it because one, it’s proof that I need help, and I don’t want you to take it personally because it’s not me talking, it’s my illness talking. I think we don’t have those conversations enough when we’re well, I think when we’re well, we want to pretend that the illness is gone and we worry about it internally and not externally. I think if we want to alleviate some stress, spending some external time when everything is normal, stereotypical, average and well,
Gabe: Educating our support system is going to go a long way.
Dr. Nicole: Mm-hmm. And that might be a great time for some family therapy. Some couples therapy. Because I can tell you, you know, the loved ones who are on the receiving end of those very hurtful words or hurtful actions or things that are completely embarrassing to them or whatever that is. It hurts. It hurts them and they don’t know how to process that all the time. And so I think the loved ones are just as guilty of not dealing with it. Once the person is stable because they don’t want to bring up what they did when they were unstable, and now they’re great. And so I don’t want to talk about it. We have to talk about it like every side has to know how their actions affect the other side. The only way that happens is if we talk about it.
Gabe: I want to swing back to my analogy when this started, where I said that you need the correct amount of stress to hold up the building. And I think when it comes to discussing bipolar disorder, its symptoms, its outcomes, its effect, etc., we need to manage that as well. Because I really see two sides here. One is that we only talk about bipolar disorder and never anything else. And the other side is we never talk about bipolar disorder until it’s an absolute crisis point. And we are forced to because of what the illness is doing. I think both of those things are wrong. And if you want to lead a truly as stress free life as possible. Then creating the right amount of stress I think is important. So we do need to have some of those discussions. We do need to have some of those postmortems. We do need to have some of that education. We need to know what’s bothering us and our loved ones. But we also need to talk about Marvel movies and music and, you know, the annoying neighbor down the street and whatever else brings you joy to have more balance. I really feel like Dr. Nicole that that gets missed because people feel like when you’re talking about bipolar disorder, you’re preventing it. And when you’re not talking about bipolar disorder, you’re allowing it to fester. And I think both of those things are untrue.
Dr. Nicole: Mm-hmm it and I get it. It takes over your life. It takes over your thoughts. It takes over. It’s the elephant in the room for a lot of people’s relationships when one of them has bipolar disorder. Yes, I agree with you because I do see both extremes in practice. I see families who talk about it ad nauseam, and the person that’s like, oh my God, quit talking to me about what I did when I was sick. I don’t want to hear it anymore. And then there are the people who just never talk about it. And there’s all kinds of hurt feelings and it never comes out. So yeah, I see that play out every day.
Gabe: I want to make sure that people have like a real takeaway and something that they can like an action step that they can take. And one of the pieces of advice that I got in therapy that I really like is don’t assume, just ask. Whatever
Gabe: That looks like. I’m going to use the example of are you mad at me? Because I think that that’s relatable. Don’t assume that somebody is mad at you. Ask them if they are. If you feel that there’s a misunderstanding, ask if there’s any misunderstandings. Now, I know that this is easier said than done, and of course it’s probably easier to do with, like your friends and your spouse or your parents than it is to do with, say, work colleagues. ButI got to tell you, I have seen a lot of people have full blown panic and anxiety attacks, worried about what somebody else thinks, and the only way to avoid that stress is just to look them in the eyes and ask them, and then consider what they have to say.
Dr. Nicole: Yeah. But I think that’s something we’re horrible at as a society of people like we’re very very bad at being honest about our differences and our disagreements and those little things without it leading to World War III. We’re just terrible at that. I mean, humans are terrible at that. Bipolar disorder or not, I just think we’re horrible at those kinds of interactions. And that is a like top tier level of engaging with other people. And those aren’t skills that a lot of us have. So just I’m just saying, don’t be upset. Don’t be too upset if you’re left more confused after you try this with somebody, because they just may not be as evolved emotionally as I don’t know. I’m just saying it’s just not a skill that a ton of folks have. So don’t be bothered or upset that you try this and you still don’t have the answers you were looking for.
Gabe: I also think part of managing stress is that understanding that sometimes we’re just not going to get the answers that we need. We need to accept that there’s some things that are just unknowable. And this is where a concept called radical acceptance comes in, where you just have to accept that you’re just not going to know how that coworker feels about you, or if your sister is really over that thing that you said at Christmas, or how somebody really feels about the thing that is eating you up inside, that you really want to know the answer to. And radical acceptance is something that, well, it it probably needs a little more conversation than just my examples. Dr. Nicole this is why I’m always super glad that you’re here. Can you talk about radical acceptance from a therapy perspective? Can you, can you can you teach it to our audience?
Dr. Nicole: Oh, yeah. Well, in two minutes? Sure.
Gabe: In two minutes. In two minutes.
Dr. Nicole: I can in two minutes.
Gabe: I’ll give you three. I’ll give you three.
Dr. Nicole: Oh, gosh. Oh, gosh. I can do you better than that. I can do you short. And I mean, honestly, radical acceptance could be a whole separate episode about radical acceptance and bipolar disorder because it is such a big topic. And I will start by saying I really do like the theory of radical acceptance. I really, really do. It is hard as all get out, but I absolutely like where this is going because I do think in mental health we’re always like, oh, you don’t want to feel that. You don’t want to feel that unpleasant emotion. Let’s try to move that unpleasant emotion out of the way. Let’s try to come up with reframing it to something else. But radical acceptance just basically says, you know, sometimes life sucks, sometimes things happen and they don’t feel good and we don’t like it. But instead of us trying to avoid it or ignore it, or instead of us wasting energy and stressing about how we wish that thing hadn’t happened, or we wish we didn’t have to deal with that thing. We just kind of accept it for what it is. It’s a sucky situation. It’s a difficult situation.
Dr. Nicole: These are very unpleasant emotions. I don’t like it, but I’m going to respect it for what it is, and I’m not going to judge myself in the process of dealing with it. Like that’s like radical acceptance in 30 seconds which I think is great, especially when you’re dealing with something like bipolar disorder, because let’s face it, it’s a, it’s a it’s a crummy situation. I often say you can’t CBT your way out of, out of or out of some things. And this is one of those things you can’t just make yourself say, let me see the more positive side of having bipolar disorder. Let me let me see what’s the positive that came out of. Let me reframe that. I call my mom a fat cow when I was manic. Let me there is no reframe like it was. It was something I did. And I need to work through that. And I need to accept that. I need to figure out how to move through this, as opposed to trying to change how I feel about it, because sometimes you just can’t. Sometimes life comes at you hella fast and it just sucks.
Gabe: I think it’s really important that once you radically accept something, you can move on from it, so you don’t need
Gabe: To worry about it anymore.
Dr. Nicole: And I like to say move through.
Gabe: Move through? Okay, alright.
Dr. Nicole: Like I don’t like to say we move on from things. Because I think when you say move on, it makes it seem like I should get over it
Gabe: I like that. I like that a lot.
Dr. Nicole: Or it shouldn’t feel unpleasant. It shouldn’t. You know, I should just move on. Like people tell you. Just move on. Like you shouldn’t even be not moving on. We’re going to move through it. And so, you know, when you go through something, you know, think about a storm, you go through a storm, you still get hit with the wind and the rain and but you make your way through it.
Gabe: And there still could be after effects, like you said with the storm,
Gabe: Right? Your your car is wet, or maybe the lawn furniture blew out of
Gabe: The way or you, you need to fix the shutters, whatever it may be. But
Gabe: You do that, you move through it.
Dr. Nicole: We move through. I prefer to move through it as opposed to moving on from it.
Gabe: But when you move through it, you’re also no longer worried about it. Again, to go back to the storm analogy, you’ve radically accepted that weather is part of life. The storm happened. You’re picking yourself up. You’re cleaning up. You may not know why it happened, and you can’t be certain that it’s not going to happen again. But you’ve just radically accepted that whatever happened, happened, and whatever is going to happen is going to happen. And ideally we’re no longer stressing about it. And I really think this stress is weighing us down, because now we’re more worried about what might happen than what actually happened. So we’ve invented a problem to worry about, to cause us stress to react to. And this is not good. Well, this is not good, period. But it’s really not good for people with bipolar disorder.
Dr. Nicole: No it’s not. And I will say, as much as I’m a big fan of radical acceptance, I think it I think that it has to be kind of developed in an environment that is very supportive, because I think the downfall of it is a person with bipolar disorder could say, well, this it just is what it is like. I have bipolar disorder. Sometimes I’m depressed, sometimes I’m manic, and y’all just got to deal with it. And I don’t have any responsibility in it because that’s also not what this is. It’s not just you saying, oh, well, I just have bipolar disorder and just allowing everything to be be swept into the bipolar disorder basket as if you have no control over your illness or how things play out. And so I do think there has to be within that radical acceptance of it. You have to be able to accept your role. And then I think where the stress relief comes in is that once you can identify what the stressful, what the pain points are for your bipolar disorder, then you can figure out how to de-stress. And it may be uncomfortable, but you can still do it.
Gabe: Now let’s talk about that uncomfortable for a moment, because this is something that people well, frankly, this is something that people don’t like. But people
Gabe: With bipolar disorder spend a large amount of their time trying to move away from things that cause them discomfort. And one of the things that causes them stress is that they cannot move away from the things that are uncomfortable. But then your advice just now is to learn to sit in that discomfort, live with it, and accept that this discomfort is part of life. Those two things seem mutually exclusive to me.
Dr. Nicole: Uhm, well, I mean, how so? I mean, you can’t avoid the discomfort. Avoiding the discomfort is largely going to add to your stress in the long run if you do all the things to avoid. I mean, we talked about how this radical acceptance is not about avoiding what happened or ignoring it, or pretending it didn’t happen. Or it’s about saying like, yeah, this is uncomfortable, but in that I can figure out one how to make it more comfortable. Like, what are the things that I can do to make it more comfortable? And what does the discomfort mean? Like discomfort isn’t always a bad thing. A lot of times when I feel uncomfortable in a situation where I am really feeling like this is not feel good, I don’t like how I’m feeling right now. There is usually something I learn about myself in that, or there’s a potential for growth in that. Sometimes it’s just like, oh, this is terrible. Like, this is just I don’t like this. And it just is what it is. But I guess I could see how you say it. It feels mutually exclusive, but discomfort is a part of life. Ignoring things. Putting your head in the ground. Pretending to be an ostrich, and just pretending like it’s going to go away is not going to help the situation in the long run, and it’s going to add to your stress down the road.
Dr. Nicole: Because then I do. I do. I absolutely do. No, because then you come into your doctor, Nicole you’re going to your therapist and you’re like, I don’t know why this thing is happening. It’s like, how did you not know? We all knew it was going to happen. How did you not know?
Dr. Nicole: And we’re back discussing stress and bipolar disorder.
Gabe: But I didn’t know. And you know, one of the things that causes me a lot of stress is the unknown. And I know we’re sort of on a radical acceptance bend, but there’s got to be something between just radically accept that you can’t know everything and preparation.Because, for example, we can radically accept that our house might catch on fire, but
Gabe: We can also radically accept that we can do things to prevent it, right? Not leave unattended candles. Right. Keep our mechanicals in good working order. Make sure our electric is good. And
Gabe: We can also radically accept that there’s preventive safety measures that we can take, like fire alarms or fire extinguishers and having a fire drill. So
Gabe: When does it become too much? Either way, to be honest.
Dr. Nicole: Okay. So let’s take that same. Let’s go down that same road with bipolar disorder. Those exact same concerns that you have, what are the things that stress you about your bipolar disorder? Those are the questions you need to ask yourself. So what are the things that are most stressful for me in managing my bipolar disorder? What are the symptoms I have that are the most stressful for me to recover from after the fact? What are those things? And then we take those steps backward, just like you are going to have the smoke alarm and the fire extinguisher and the carbon monoxide monitor and all the things in your home to protect you in that way. Then let’s do those same things and have those same things in place for your bipolar illness. If spending is something that is a huge stressor for you, and you find that you are always, during the manic phase, overspending, overextending yourself, putting yourself in situations that it takes you months, years to to dig out of after the fact. Then we can we can put things in place for those things when you’re stable. So we’re talking about things like freezing your credit, right? If your credit is frozen, you can’t impulsively just go decide to do something big without multiple steps happening to get you there. And sometimes that can be helpful to have to create barriers for yourself. I mean, I have people who don’t even hold their credit cards. They have someone who’s very close to them or a loved one physically hold their credit cards because that helps them in situations like this. Like, these are little things. They seem like little things when you think about it, but really they can be very big things if these are things that are very stressful for you. If you’re someone who during your depression, one of the things that stresses you the most is your diet. Maybe you have another illness like diabetes, and your control of your diet is extremely important. Maybe you are one of those people who’s going to go carb crazy, or sweets and candies and things like that. Maybe you decide, okay, my way to deal with that stress of coming out of this thing and then realizing my sugars are all crazy is for me to just not have those things around. It’s for me to meal prep and have frozen meals available because I know in my depression, I’m going to do the easiest thing. If that’s the easiest thing I can, then make sure I do that. Whatever your stress thing is with your bipolar disorder and everybody’s going to be different, why can’t we use that same house fire analogy to to apply to those things.
Gabe: An interesting thing is happening in this conversation, Dr. Nicole, right? We’re trying to find examples that relate to the average listener, so that the average listener can hear themselves in this and they can apply it to their own situation. But we’ve sort of accidentally uncovered that this is actually how people tend to think about it. It’s not specific. They say things like, I’m worried that everybody hates me. I’m worried that I’m going to lose my job. I’m worried that something bad is going to happen. And these things cause us vast amounts of stress. But yet we take no time to actually find the I’m worried about the fight I had with my sister, or I’m worried that that project that I completed wasn’t up to my normal par, and my boss is going to notice that and that, like those are very specific, right? So
Gabe: I really think that one of the things that we can do to alleviate stress is to, is to be more specific. I’m worried that everybody hates me is way too broad. Abroad. I don’t even know how like that is. That is so huge.
Gabe: I’m worried that my sister is still mad at me because of the fight we had at Christmas. That’s very
Gabe: Specific. And then you can start making action items. So from a, a from a from a doctor perspective, right. From a medical perspective, when somebody comes to you, Dr. Nicole and says, I’m worried that something bad is going to happen, I’m having constant stress, constant worry, constant panic, constant anxiety. It is crippled me in every way because something bad is going to happen. You obviously probably ask them some follow up questions. What are those follow up questions?
Dr. Nicole: Yeah. You think so?
Dr. Nicole: You think? Yeah. Yeah.
Dr. Nicole: You think? You think I probably do? Yes.
Gabe: I know everybody wants to believe that you just throw pills randomly at people and tell some, you know, insipid story
Gabe: About how they can do better, but that’s not how it actually works.
Dr. Nicole: No, it’s not.
Gabe: Part of solving the problem is identifying the problem.
Dr. Nicole: No it’s not. And as you, as you were saying, all of that, it it led me to a place of. It’s important to bring this up with your Dr. Nicole with your therapist if you have one, because maybe we’re dealing with something in addition to your bipolar disorder, right? Maybe this isn’t just stress, just dealing with stress. Maybe this is a full on anxiety disorder that we need to try to deal with and address. In addition to your bipolar illness, there are a lot of people who have both an anxiety disorder and bipolar disorder. You can have both. You are not limited to one disorder. Unfortunately. I know a lot of you are like, listen, I don’t have time to have multiple psychiatric disorders, but but that is the reality for some people. You are not limited to just one. You can actually have a generalized anxiety disorder in addition to your bipolar disorder. And so we want to make sure that we’re not writing off oh that’s just stress. That’s just everyday stress stuff. And this could be something bigger. So I do think it’s important to bring it up if you are having that. Because really, if you’re constantly worried that something bad is going to happen on a more global level and you really can’t pinpoint like, I am worried about this one specific thing, there may be something deeper that’s wrong and you may want to talk about that. So I would absolutely start asking questions about the worry. What kinds of things are you worried about? Is it specific to things that happened in the context of a of a mood disorder in your bipolar disorder, or are you just worried about all kinds of random things? And we would talk about how those worries are affecting you, or are you able to relax or are you restless? Are you more irritable? Like, we can talk about all those things because I’m trying to figure out, is this exclusive to the fallout of an episode, or is this more of a generalized worry, and is this something else I have to be concerned about?
Gabe: I think there’s an incredible amount of value like Gabe the podcaster. Gabe, the mental health advocate, thinks that there’s just such an incredible amount of value to pinpoint exactly what’s bothering you. Face it head on, deal with it. You use a coping skill, get it out of the way and move forward. And I know that that relieves so much stress, but I’m going to call bullshit for a minute. When I think
Gabe: About Gabe, who lives with bipolar disorder, I think about the 3 a.m. I’m going crazy and everything is terrible and everything is awful, and I know bad is coming. I don’t think bad is coming. I’m not. I’m not concerned. I know bad is coming. It’s it’s nebulous. It’s basically smoke at this point. It just it just it just fills all the room and it’s
Gabe: Terrifying and scary. Do you have any advice for those moments? Because those are those are both scary to live with, right? I want to be very clear. It’s a two pronged question. Those are scary moments to be in, but they’re so scary that you worry about them happening again.
Dr. Nicole: Yeah. I mean this is hard because I completely get what you’re saying. I, I can almost visualize this because I see people who are in the hospital or who, who their symptoms have led to hospitalizations. They felt such despair. And sometimes it can just take over everything. So I do I get that. You know, in those moments, I think they’re everybody’s going to be different. Everyone’s going to be different about what’s going to be helpful to them in those moments. For some people, it’s distraction. For some people, it’s knowing that I have these people that I can be around when I feel this way. And you don’t even have to say, hey, I’m in a dark place today. I need to come hang out with you. But we all have those people in our lives that when you’re down, you know that there are certain people you can surround yourself with, you can call and they’re going to distract you. They’re going to lift you a little bit. It’s important to have those people in our lives, even if they have no idea the role they play for you. It’s important to have those activities and those people spaces that you can go. For some people, it’s a place for some people. I have had a couple of patients who have, who have loved the 24 hour nature of a waffle House or an IHOP because they know they can go in there and they can, you know, just kind of sit and and there are people there and there’s movement and there’s things going on.
Dr. Nicole: Not that I encourage everybody to go spend your nights at waffle House or IHOP. However, for some people, that has been a very valuable tool at that 2:00 Am, when I’m feeling very dark and everybody’s asleep and I don’t really want to bother anybody, I know that I have a place that’s open 24 over seven I can go to, and they kind of make small talk with the wait staff and, you know, little things like that that has been invaluable for them. I have some people who journaling is what is most valuable for them during those moments, because in their journaling, they’re usually able to identify more specifics about what’s bothering them. Sometimes you think, well, I don’t really know. I just think everybody in the world is mad at me. I can’t even come up with a person. I can’t even come up with specifics. But if you start writing and you start writing it out, they’re going to be themes that you see, and we’re going to see things and we’re going to go, oh, so that’s what’s upsetting me. And sometimes people have come back and they’re like, I figured it out.
Dr. Nicole: Like I wrote about the same thing, like four nights in a row. I didn’t even know that was the thing. Sometimes it’s journaling. For some people, it is meditation. It works really well for them in helping them to ground themselves and clear their thoughts. For some people, that’s what it is. For some people, it’s breathing exercises, like everybody has their thing and sometimes you have to try a couple things, maybe 3 or 4 things until you find your thing. But there are all kinds of things out there that you can do to help you in those dark spots. And then the goal is to take that back to your Dr. Nicole. And like, I’m having this many dark nights. So we’ve talked about tracking moods. I’m a big fan of mood tracking, because I also think tracking moods can help. If you’re somebody who you’re worry is, I’m going to get sick again, I’m going to have an episode again. Something bad’s going to happen. I’m going to have an episode. Sometimes it’s helpful to track because you can see that you’re having really good days that don’t involve mood episodes. And maybe the biggest stress is that you’re worrying about something that hasn’t even happened, so that that may be helpful, but it’s also helpful for your Dr. Nicole to know, like, what are these dark times that you’re having? Are they only happening at night? Are you fine during the day? But then at night, everything falls apart.
Dr. Nicole: Like we need to see the patterns to know what we can do to help you through them. But there’s a million things you can do. So I really don’t want to say do this one thing. I will say there’s a million things. If you haven’t been hospitalized, they always give you that list of like 100 coping skills. They if you if you’ve ever been hospitalized, they always give you that. Like here’s a list of 100 coping skills that you can use. And I know it sounds dumb because patients are always like, this is stupid, this list is dumb. And I know it seems dumb on the surface, but there is somebody who’s going to take a shower and go, oh, this is an amazing coping skill, and then somebody else is going to do it and go, this is dumb. Now I’m clean, but still worried about all the crap I was worried about before, or I’m still depressed. Everybody’s going to find their thing. So be open to that dumb list of 100 coping skills, because you never know which is going to be your thing.
Gabe: I am guilty of insulting that list, and I am guilty of insulting things like this. And I want to be honest with the audience. I don’t think the coping skills that I use have ever appeared on one of those 100 things to to try when you’re X, but I will say this the very act of trying those things was a coping skill in and of itself. Even when they didn’t work, they were a distraction. And when I thought about it, I felt empowered, like, hey, I tried this and it didn’t work. Now some of my thoughts were, this is so stupid, I can’t believe this didn’t work. These doctors don’t know what they were doing. But I got to tell you, that was a different thought than something bad is going to happen. The world is coming to an end. Now I’m distracted. So so one, I think there’s real value in trying as many coping skills as possible because you just don’t know. You just don’t know what one
Gabe: Is going to work for you. But two, there’s real value in trying the coping skill and having it fail because it’s a distraction and it gets you one step closer. Dr. Nicole I want to swing it around before we end the show, because it is. It is never lost on me that the vast majority of things that humans worry about never happen. The things that get humans. And I noticed, I didn’t say people with bipolar disorder. I said humans.
Gabe: The vast majority of things that humans worry about never happen. It’s always that thing that we didn’t see coming that gets us. It’s very human nature to be worried about things that we can’t control or that, well, frankly, are scary. And I think that bipolar disorder has a way of amplifying that. And that’s why it’s really important for us to be aware of it. But I think that people with bipolar disorder are just like everybody else, and that there are scary unknowns out there that occupy our brain space and that many, if not all, of the techniques that the average person uses to manage their own fears, worries, concerns will work for us. We might need to give them a little extra, a little extra gas or or juice it up a little. Or as Tim the Tool Man Taylor said, more power, more power. But but at its core, I think this is just a very human thing, that bipolar disorder has just sort of added a little bit to. So I, I do want to point out, I don’t think people with bipolar disorder are all that different from the rest of the population.
Dr. Nicole: No, no. And I think we have to we have to be real about the fact that the world is a very scary place right now. There are so many very strange things going on. There’s so much scary stuff out there. It’s easy to get weighed down with a lot of that stuff. And I do know for a fact a lot of people are dealing with that, not just the folks with bipolar disorder. But when you do have bipolar disorder, we know that you’re a little bit more susceptible to the stressful things in life, and that’s why we’re talking about it today.
Gabe: Being aware of it is the first step to resolving it and being really aware of it. Not just this nebulous idea, but really narrowing down what is worrying you. Being able to ask others for help is very, very, very important. Being able to try different things is very important. So many people are so focused on the stress that they’re not focused on resolving stress, managing stress or mitigating stress. Also, and I really feel this is probably one of the most important takeaways for this entire episode. You have to believe that you can get through it. You have to believe that you can manage it and that you can do it and that and that that a better life is possible. And if you are not there yet, then there are other things that you need to do. And this this episode may be a little premature for you. You need to get with your Dr. Nicole’s. You need to get with your support system. You need to get with your help and say, I am not capable in this moment of seeing a brighter future, because that in and of itself is a very serious symptom of bipolar disorder . So it might not necessarily be your fault that you can’t move forward. You may need
Gabe: Outside intervention.
Dr. Nicole: Yeah. And it’s okay to bring it up with your Dr. Nicole so often people will be dealing with things and not even tell me that it’s something they’re dealing with until some kind of round about way we get to it and they go, oh yeah. Well I mean I have been super stressed about a b c d e, f g. They go down the alphabet. Of all the things they’ve been worried about. And they just never bring it up because they say, well, I mean, I just thought that was just life. Everybody’s worried. Everybody’s stressed. I just thought that was just life. So it is important, I think, to bring those things up, because sometimes you may get told that’s a pretty normal worry. That’s a pretty typical stressor. I think a lot of people are dealing with that. Or more questions may be asked and you may be told, or maybe there’s something more going on here than maybe you thought. So definitely bring it up. Don’t be afraid to bring it up, because we won’t know if you don’t bring it up.
Gabe: Dr. Nicole, thank you so much for being here. And to our listeners, thank you as well. You know, I always think it’s weird, Dr. Nicole, that I thank you for being here. Like you have to be here. There’s
Gabe: No show without Dr. Nicole.
Dr. Nicole: You do. [Laughter] You do.
Gabe: I do it at the end of every episode. I do it at the
Gabe: End of every single episode.
Dr. Nicole: And I just smile and nod, Gabe, I just
Dr. Nicole: Just smile and nod.
Gabe: Every single time. But Dr. Nicole and I are both super thankful that you are here and we want some favors. First. Wherever you downloaded this episode, please follow or subscribe to the show. It is absolutely free and you don’t want to miss a thing to tell people about the show. Text people, email people. Post your favorite episodes on social media. Leave us a comment. Leave us a happy message. Email show at PsychCentral.com. Just spread the word about the podcast, because sharing the show with the people you know is how we’re going to grow. And with that, my name is Gabe Howard and I am an award winning public speaker and I could be available for your next event. I also wrote the book “Mental Illness Is an Asshole and Other Observations,” which you can get on Amazon because everything is on Amazon. But you want to go to my website and get a signed copy, which is ultra cool. Just head over to gabehoward.com.
Gabe: And we will see everybody next time on the Inside Bipolar
Announcer: You’ve been listening to Inside Bipolar from Healthline Media and psychcentral.com. Have feedback for the show? E-mail us at [email protected]. Previous episodes can be found at psychcentral.com/ibp or on your favorite podcast player. Thank you for listening.
link
